巢元方论曰∶诸筋会于阴器，邪客于厥阴少阴之经，与冷气相搏，则阴囊肿痛而引
缩，经中虽分四证，曰肠 、气 、水 、卵 。然小儿患此，若治之不早，则成痼疾，如
腰曲腹痛，冷汗自出，而阴囊二子，吊缩入腹，痛止方出，名为内吊。用乌梅散匀气散、
金茱丸、金铃散为治。有阴茎全缩不见，有阴囊光肿不痛，此因肝肾气虚。宜以橘子仁
煎汤，调下金铃散、匀气散，皆可投之。《内经》曰∶ 癃疝肤胀者，阴亦盛而脉胀不通，
故曰 癃疝。由是观之，乃阴气盛而致有此吊缩者，筋急也。筋遇寒则引缩，遇热则纵
弛，故三因所用方法，以宽小肠气疏风为治。然小儿此证，多因坐阴润之地，惑风湿而得，
用当归散加槟榔、苍术，水、姜煎服，并青木香汤、钩藤膏，外以立消散傅之。有外肾
无故而肤囊肿大，不燥不痛，光亮如吹，此名气虚所致，以匀气散调治，三因方家韭子
丸主之。一证外肾肤囊赤肿通明，及女儿阴户肿胀，乃心热之所传，皆以木通散、导赤
散为治，或用薏苡仁煎汤，调五苓散，及以外消散敷之，并投天花散，用无灰酒煎下。不
能饮者，水煎少入酒，同服亦好。
肝者，东方青龙木也。其动则应于风，病则主惊骇。诸热引肝风．有风则生痰，有痰
亦作搐。小儿惊风之际，手足动掣，当听其自定，然后疗之，免生异证。或父母见其病
势可畏，从而按伏之，岂知筋者肝之令也。临病发时，若按束其手足，则筋不舒伸，遂至
经络为风所闭，终为废人。内经曰∶顽弱名缓风，疼重名湿痹。又有四肢痿痹不仁，致
手足稍胀痛不堪忍者，此风毒之气使然。故传曰∶风淫末疾是也。凡小儿心悸不常，及
遍身肿痛，或手足不随，此为惊瘫候也。若治之稍迟，至臂腕膝胫骨节之间，流结顽核，
或膝大而肿，肉消骨露，如鹤膝之状，或为痈为疖，此名鹤膝候也。以上形证，并宜发
汗为先，使腠理开通，则风热可除，有湿亦去，用百解散和 咀五苓散，倍加麻黄，水、
姜、葱煎服，微得汗为度，或以麻黄汤发散尤佳，次防己汤、祛风散，及独活汤加桑寄
生投服，并防风汤或黑虎丹，作小丸子间服，使风不生而痰不作，则其疾易愈。若为痈
为疖，疼重者用黑牵牛半生半炒，略碾碎，煎无灰酒调下五苓散，以除流注之寒湿，则肿
毒可消。如大府闭而不通，此是风热内蕴，其右腮红紫，及右手三部脉浮而实滑，宜五和
汤或当归散、枳壳丸治之。其加减之法，尤在临机审处。若泥一方，非良医也。前证更宜间服排风汤。
巢元方论述说：所有的筋汇聚于阴器（外生殖器），邪气侵犯足厥阴肝经和足少阴肾经，与寒气相互搏结，就会导致阴囊肿痛并牵引睾丸收缩。虽然经络中将此病分为四种证型，即肠疝、气疝、水疝、卵疝。然而小儿患此病，如果治疗不及时，就会变成顽固性疾病，出现腰部弯曲、腹痛、冷汗自出，以及两侧睾丸吊缩进入腹腔，疼痛停止后才出来，这叫做“内吊”。使用乌梅散、匀气散、金茱丸、金铃散进行治疗。有的阴茎完全缩回看不见，有的阴囊光肿但不痛，这是因为肝肾气虚。适宜用橘子仁煎汤，送服金铃散、匀气散，都可以投用。《内经》说：癃疝肤胀者，是因为阴气盛而脉道胀满不通，所以称为癃疝。由此看来，这是阴气盛而导致这种吊缩的症状，属于筋脉拘急。筋遇到寒冷就会收缩，遇到热就会松弛，所以三因方所用的方法，以宽理小肠气、疏风为治疗原则。然而小儿此证，多因坐在阴冷潮湿的地方，感受风湿之邪而得，使用当归散加槟榔、苍术，用水、生姜煎服，并配合青木香汤、钩藤膏，外用立消散敷贴。有的外生殖器无故皮肤肿胀变大，不干燥也不痛，光亮如吹起的气球，这叫做气虚所致，用匀气散调理治疗，三因方家的韭子丸主治。一种证候是外生殖器皮肤红肿通明，以及女童阴户肿胀，这是心热所传变引起的，都用木通散、导赤散治疗，或者用薏苡仁煎汤，调服五苓散，以及外用消散敷贴，并服用天花散，用无灰酒煎服。不能饮酒的人，用水煎药时少量加入酒，一同服用也很好。
肝，对应东方青龙，属木。其变动应验于风，发病则主惊骇。各种热邪引动肝风，有风就会产生痰，有痰也会引起抽搐。小儿在惊风发作之际，手足抽动，应当听任其自然安定，然后再进行治疗，以免产生其他病变。或者父母见病情势态可怕，从而按压束缚患儿，哪里知道筋是肝的号令。临病发作时，如果按压束缚其手足，则筋脉不能舒展伸展，最终导致经络被风邪闭塞，终成废人。《内经》说：顽弱称为缓风，疼痛沉重称为湿痹。又有四肢痿软麻痹不知痛痒，导致手足稍微胀痛难以忍受的，这是风毒之气使然。所以传论说：风邪淫溢会导致四肢末端的疾病。凡是小儿心悸不安，以及全身肿痛，或手足不能随意运动，这叫做惊瘫候。如果治疗稍晚，到了臂腕膝胫骨节之间，流注凝结成顽硬结节，或者膝盖大而肿，肌肉消瘦骨骼外露，像鹤膝的形状，或者成为痈疮疖肿，这叫做鹤膝候。以上形证，都宜以发汗为先，使腠理开通，则风热可除，有湿邪也能去除，使用百解散合五味子、五苓散，加倍加入麻黄，用水、生姜、葱白煎服，微微出汗为度，或者用麻黄汤发散尤其好，其次用防己汤、祛风散，以及独活汤加桑寄生投服，并配合防风汤或黑虎丹，制成小丸子间隔服用，使风不生而痰不作，那么疾病容易痊愈。如果成为痈疮疖肿，疼痛沉重的用黑牵牛半生半炒，略加碾碎，用无灰酒调服五苓散，以除去流注的寒湿，那么肿毒可以消除。如果大便闭结不通，这是风热内蕴，其右腮红紫，以及右手三部脉浮而实滑，适宜用五和汤或当归散、枳壳丸治疗。其加减之法，关键在于临机审慎处理。如果拘泥于一方，不是良医。前证更宜间隔服用排风汤。
Niao Yuanfang stated: All sinews converge at the genital organs. When pathogenic factors invade the Jueyin Liver meridian and Shaoyin Kidney meridian, and contend with cold qi, it results in swelling and pain of the scrotum with retraction of the testes. Although the meridians divide this condition into four syndromes—namely Chang Han (Intestinal Hernia), Qi Han (Qi Hernia), Shui Han (Water Hernia), and Luan Han (Testicular Hernia)—if pediatric cases are not treated early, they may become chronic ailments. Symptoms include curvature of the waist, abdominal pain, spontaneous cold sweating, and the two testes retracting into the abdomen, emerging only when the pain subsides; this is named Neidiao (Internal Retraction). Treatments include Wumei San (Mume Powder), Yunqi San (Harmonizing Qi Powder), Jin Zhu Wan (Golden Dogwood Pill), and Jinling San (Golden Belladonna Powder). In some cases, the penis completely retracts and becomes invisible; in others, the scrotum swells brightly without pain, caused by deficiency of Liver and Kidney qi. It is appropriate to decoct Tangerine Peel (Chenpi) and administer Jinling San or Yunqi San with the decoction. The *Neijing* states: "In cases of Long Shan (Urinary Obstruction Hernia) and skin distension, Yin qi is excessive while pulse vessels are swollen and obstructed, hence it is called Long Shan." From this perspective, such retraction is due to excess Yin qi causing spasm of the sinews. Sinews contract when exposed to cold and relax when exposed to heat. Therefore, methods from the *San Yin Fang* focus on relaxing the Small Intestine qi and dispersing wind. However, this condition in children often arises from sitting in damp, cold places and contracting wind-dampness. Treatment involves Danggui San (Angelica Decoction) added with Areca Seed (Binglang) and Atractylodes Rhizome (Cangzhu), decocted with water and ginger, combined with Qingmuxiang Tang (Blue Musk Tang) and Gouteng Gao (Uncaria Paste), externally applied with Lidisan (Immediate Dispersal Powder). If the external genitals swell spontaneously without dryness or pain, appearing taut like an inflated balloon, this is attributed to Qi deficiency, treated with Yunqi San, primarily managed by Jiuzi Wan (Leek Seed Pill) from the *San Yin Fang*. Another syndrome presents with red, swollen, and transparent external genitals, or swollen labia in girls, transmitted from Heart heat, treated with Mutong San (Akebia Powder) or Daochi San (Directing Red Powder), or alternatively, Coix Seed decoction administered with Wuling San (Five-Ingredient Powder with Poria), externally applied with Xiaosan (Dispersal Powder), and internally taken with Tianhua San (Trichosanthes Powder) decocted with pure wine. For those unable to drink alcohol, a small amount of wine can be added to the water decoction.
The Liver corresponds to the Azure Dragon of the East and belongs to Wood. Its movement responds to Wind; pathology manifests as fright and terror. Various heat pathogens stir Liver Wind; when Wind is present, Phlegm is generated, and Phlegm can also cause convulsions. During pediatric Jing Feng (Convulsive Disorder), when limbs twitch, one should allow them to settle naturally before intervening, to avoid inducing other complications. Parents, fearing the severity, may restrain the child's limbs; however, sinews are governed by the Liver. Restraining limbs during an attack prevents sinews from extending, leading to obstruction of meridians by Wind, potentially resulting in permanent disability. The *Neijing* states: "Flaccidity is termed Huan Feng (Slow Wind); heaviness and pain are termed Shi Bi (Damp Bi)." There are also cases of flaccid paralysis and numbness in the four limbs, causing unbearable slight swelling and pain in hands and feet, caused by Wind-Toxin. As the transmission states: "Wind invading excessively leads to diseases of the extremities." Whenever a child experiences palpitations, generalized swelling and pain, or inability to move limbs freely, this is the Jing Tan Hou (Fright Paralysis Syndrome). If treatment is delayed, phlegm-stasis may accumulate in joints of arms, wrists, knees, and shins, forming hard nodules, or knees may swell significantly with muscle wasting exposing bones, resembling the knee of a crane (He Xi Hou/Crane Knee Syndrome), or develop into abscesses and boils. For these presentations, diaphoresis (sweating) should be prioritized to open the couli (pores), thereby dispelling Wind-Heat and Dampness. Use Baisan San (Hundred-Dispersion Powder) combined with Wu Ling San, doubling the dose of Ephedrae Herba (Mahuang), decocted with water, ginger, and green onion, aiming for mild sweating. Mahuang Tang (Ephedra Decoction) for dispersing is particularly effective. Subsequently, Fangji Tang (Stephania Decoction), Qufeng San (Wind-Dispersing Powder), or Duhuo Tang (Angelica Pubescens Decoction) added with Sangjisheng (Taxillus) may be used, along with Fangfeng Tang (Saposhnikovia Decoction) or Heihu Dan (Black Tiger Pill) in small doses intermittently, ensuring Wind does not arise and Phlegm is not produced, facilitating recovery. If abscesses or boils occur with severe pain, use half-raw and half-fried Semen Kansui (Heiqian Niu), slightly crushed, taken with Wuling San dissolved in pure wine to eliminate flowing Cold-Dampness, resolving the swelling and toxicity. If bowel movements are blocked, indicating internal accumulation of Wind-Heat, accompanied by reddish-purple right cheek and floating, solid, slippery pulses in the three positions of the right hand, treat with Wuhe Tang (Five-Harmony Decoction), Danggui San, or Zhike Wan (Citrus Aurantium Pill). Dosage adjustments depend on clinical judgment; adhering rigidly to one formula is unwise. Additionally, Paifeng Tang (Wind-Expelling Decoction) should be taken intermittently for these conditions.